Do you have a prescription for a wheelchair or durable medical equipment? Then be sure your physician has enrolled in the Medicare internet based PECOS system or good old Medicare may not pay for it.
Starting April 5, 2010 physician and non-physician practitioners must be enrolled in the Medicare internet based PECOS system to order durable medical equipment prosthetics orthotics and supplies for you.
For any item to be covered by Medicare, it must be ordered by a physician or nonphysician practitioner who is eligible to order such items. The providers who can order items include: doctor of medicine or osteopathy; dental medicine or dental surgery; podiatric medicine; and physician assistant, certified clinical nurse specialist, nurse practitioner and optometrist.
Do yourself a favor! Download this letter (PDF), print it, and show it to your doctor to make sure that they are enrolled in this program. It’s not an option, no enrollment means no equipment for you. Get it done! Oh ya, please.
A while back I posted on A Father’s Powered Wheelchair Lament. A sad situation regarding a daughter’s new wheelchair that was fraught with problems.
It appears that the saga continues. Not only were there issues with the new wheelchair but it appears that the chair configuration (specified components) and getting repairs and support have also become an issue.
As in any industry, quality of service delivery can be a wildcard and vary greatly from company to company. Unfortunately, for wheelchair users the downside can easily become the case since after sale support by the medical equipment dealer is often directly tied to profits made on the original sale of the wheelchair.
As for how knowledgeable dealers are regarding wheelchair products and real world wheelchair use, well, I’m sure that also varies greatly throughout the industry.
“The parts on the wheelchair are entirely different from what the owner’s manual shows and says must be used and have been tested. And the manufacturer has still not simply said, “you have a new version” or “what you have has been safety tested.” No, they say nothing, silence is golden.”
“During that incident, I called multiple DME companies in my area. This is important: each and every one said they would not sell me a part, nor repair the chair if they did not sell the chair to me originally.”
Referring to the National Registry of Rehabilitation Suppliers(NRRTS) code of ethics:
“Maybe I don’t understand English. If I have the right to work with the supplier of my choice, why won’t any supplier work with me? This is an emergency, I will pay cash for a simple part, but no, they won’t work with me.”
“Study before you buy that wheelchair. Ask questions. Demand answers. Read the manual. Talk to friends, talk to me! Make sure your PT, OT or physician approves of EVERYTHING because that wheelchair sales person is just that, a sales person.”
Getting where you want to go in a wheelchair, out of necessity or for recreational purposes has always been the real motivator behind wheelchair design.
Many a one-off or niche wheelchair has been designed in makeshift workshops and in design labs in order to fulfill the dreams of sports and recreational minded wheelchair users. None have been more prolific of late than off-road wheelchairs. It seems that more and more wheelchair users are deciding to venture into places that civilization and ADA have left untouched.
Here is the latest off-road wheelchair entry from Argentine designer Francisco Lupin.
This off-roader (above) is a three wheeler with the two large wheels up front where they can do the most digging (large wheels handle rough terrain better than small wheels). The wheelchair is designed with a suspension system at the seat rather than at the wheels to cushion the ride. The front wheels are camber adjustable and the frame is finished in a fiberglass monocoque.
Three wheeled manual wheelchairs are not a new concept at all and have frequently been used in the design of racing wheelchairs, tennis wheelchairs, and other sports and everyday wheelchairs. The concept goes back quite a ways as can be seen in the image on the right.
It looks like the Mobility Conquest wheelchair accessible trike finally made it over to the USA.
Four Mobility Conquest trikes arrived from the UK to the MobilityWorks Commercial facility on Wilbeth Road in Akron to begin the bike’s release into the U.S. marketplace. One of the motorcycles will be transferred to the Consumer showroom at 810 Moe Drive, Akron Ohio shortly. The other three trikes will make their way to other MobilityWorks locations in the coming weeks.
The four Conquest imports are just the start of 45 (forty-five) total wheelchair accessible trikes scheduled for delivery to the United States within the next two to three months. They will be distributed to a network of authorized mobility van dealers throughout the country.
Manufacturing of the Conquest will then take place by the MobilityWorks Commercial Manufacturing Division. All Conquests are built around brand new BMW motorcycles. The bike is capable of going 0-60 MPH in 7.6 seconds and a 15-second quarter mile time. They have been proven over several years (in England and Europe) to deliver superior performance, maneuverability and paraplegic wheelchair driving capabilities.
Can things go wrong with a new wheelchair? Will things go wrong with a new wheelchair? Is it bad luck or state of the industry?
A father laments the condition of a brand new powered wheelchair ordered for his daughter. Here are some out-takes. You can read the entire post at http://www.disableddaughter.com/?p=1309
I only have multiple engineering degrees and this is our fifth chair, so I may not know what I am talking about, so can you help me out?
Brand new, delivered wrapped in plastic, new fresh scratches! I wonder if we paid extra for them, the thing only cost about $6000.
There are cables for the reclining back that are twisted and in the way for the included backpack to be hung (i.e.: I also purchased their backpack for the chair which cannot go on the chair because they put the cables in the way).
We learn that when the chair is ordered all the parts are input into the manufacturer’s computer for said order, if a particular size frame, and specific size casters, and this footrest are input, a “soft red flag” pops up. A “hard red flag” means “no way will we sell this combination of parts.” A “soft red flag” means “tell the customer this is a dumb combination of parts and problematic and see if they really really want it.” My combination raised a soft red flag. SL was never told. I was never told. So the manufacturer sold me a chair that they knew was sub par.
SL gives me papers to sign, I can’t tell you what they said since he did not have a copy to leave with me, but will send them by email in the morning. Never got them.
This means that even if you change the axle on the casters, which may allow them to work at zero tilt, there is a good chance that the added inch (from moving the axle to the lower hole, one inch down) will prohibit Pearlsky from being at the table with all of her classmates since that inch must go somewhere, in this case raising her knees.
What’s next for health care no that the Senate gangbang is over?
The following update from Kaiser Health News may give you some insights as to what may yet lie ahead on this bumpy road to health care reform.
“Now that the Senate has passed a hotly debated health care bill, Congress is headed to the next step: House-Senate negotiations in January to hammer out a final version. Given the Senate’s difficulty in passing a bill, the final legislation is likely to tilt strongly toward that chamber. Here’s where things stand and how you might be affected.
What are the biggest disputes?
There are scores of disagreements, but the biggest battles will come over how the legislation would be paid for, whether to include a government-run insurance plan and how much to spend on subsidies to help lower- and middle-income Americans afford insurance. “
This minimalist wheelchair was designed for Bryan Anderson spokesperson for Pride Mobility, and a triple amputee who needed a manual wheelchair to match his active life.
Bryan has a super active lifestyle and needed a wheelchair to match. Designer Mark Veljkovich came up with this efficient and highly mobile design just for the occasion.
This wheelchair right here aims to enhance “the great personality of this extreme individual.” You’ll notice that this wheelchair is extremely minimal. It’s got only that which the advanced wheelchair users needs. Wheels, chair, wheelchair.
Super simple, fold-downable in a moment, carbon fiber, disk breaks.
A group of students at Michigan Tech pulled together to develop a human push powered off road wheelchair.
“The team had to overcome some challenges,” said sponsor John Beard, associate professor of mechanical engineering-engineering (ME-EM) mechanics. “They had to keep it fairly lightweight, since it was going to be self-propelled. And it had to stop before rolling backwards. They accomplished both. It can even go up a 28-degree slope.”
The goal of this project and similar projects Beard and his students have undertaken is to create vehicles and systems that the disabled can use without paving the Tech Trails, keeping the outdoor nature trails as natural as possible.
Students on the team spent an average of 140 hours each on the design of the wheelchair and ultimately came up with the Human Powered Off-Road Wheelchair. The wheelchair has machined parts, and the metal is coated to protect against the elements. Other features included one-way bearings for zero rollback, a total weight of 55 pounds, a consistent color scheme for aesthetics, a suspension seat to minimize pressure points, the ability to accommodate a range of heights—and it was all built under their $3,000 budget.
The wheelchair will be stored and used at the school’s Tech Trails once completed.
Interesting doings in Eugene, Oregon over wheelchair accessible taxi rates.
EUGENE, Ore. — Is it discrimination — or just someone trying to run their business?
The City of Eugene effectively shut down Budget Taxi’s wheelchair-accessible van service because they charge more money for the van than for a regular taxi.
City officials say the different charges violate the federal Americans with Disability Act. The Business License Coordinator told Guelld she would lose her license unless she changed her wheelchair van rates to be consistent with the rest of her fleet, or gave up this service entirely.
The owner of the cab disagrees with this action.
“Just because you’re disabled does not mean the only place you go is the doctor,” said Denise Guelld, owner of Budget Taxi. “They go out at night, they go to bars, they go to grocery stores, and to take away their only transportation is bull.”
The recent AARP article on Medicare’s cost of powered wheelchairs stirred up quite a bit of noise among consumers and advocacy organizations.
Paul Tobin, President of United Spinal Association sets the record straight:
A sloppy, wildly inaccurate story about power wheelchairs by Jim Toedtman that appeared in the November 2009 issue of AARP Bulletin was rebutted in the December issue of the Bulletin by Paul Tobin of United Spinal Association.
Tobin writes in a letter to the editor, “‘The Case of the Expensive Wheelchair’ compares prices Medicare paid for wheelchairs versus the cost to suppliers and assumes the difference is due to fraud. We’re dead set against Medicare fraud, but this assumption fails to recognize that wheelchairs–like people–are not fungible. A person with permanent paralysis needs an individualized wheelchair. Someone 6 feet 4 inches tall, paralyzed from the neck down with little use of hands, who depends on a breathing tube, needs a power wheelchair with individualized electronic controls and room for oxygen supplies. Adapting wheelchairs to an individual is essential and requires professional consultation. That’s why they cost more than something bought off the shelf.
Tobin was being polite. The AARP story was extraordinarily misleading.
AARP Bulletin incorrectly assumed that the only cost of providing a wheelchair in the home of a person with disabilities is the acquisition cost.
The misconceptions voiced by AARP can be easily dispelled- Seeing is believing. Here are two configurations of the same powered wheelchair (Invacare TDX). Do they appear to be configured for users with different needs? Would one think that the more technically involved configuration would cost more than the base model? I would hope so, and in fact it does. The unit on the left is approximately twice the price of its little brother.
Add to that other needed features that might include aggressive positioning devices and specialized control systems and you add yet another cost factor. Wheelchair "options" are not at all similar to automobile options. It’s not a matter of "wanting" certain options because they look cool or stand out. It’s a matter of needing these options so that the wheelchair is "usable" and so that it does not further complicate clinical and functional issues that the user may have.
If you want to see what it takes to put a high end rehab wheelchair together then have a look at this order form for a Sunrise Medical product. It starts off with a base wheelchair at a base price but depending on user need it can go through some radical physical and cost changes. Click here to view form (PDF).
I’m not sure why the pricing of powered wheelchairs is so difficult for people to understand. It’s actually very simple. The more involved the wheelchair user’s needs are the more technically intricate the wheelchair becomes. The more technically intricate the wheelchair becomes the more it costs. A very mundane concept that holds true for more than just power wheelchairs.
It becomes much easier to grasp when you think of of the wheelchair as a combination of building blocks or Lego pieces and give equal weight and consideration to the users physical and functional needs. How many pieces does it take to make the wheelchair appropriate for a specific user. The more pieces the higher the cost. And of course each user is different so costs may vary greatly from user to user.
